A nurse who is active in local consumer mental health groups and in local and state
mental health associations and who keeps aware of state and national legislation
affecting mental illness treatment may positively affect the climate for treatment by:
A) becoming active in politics leading to a potential political career.
B) reducing the stigma of mental illness and advocating for equality in treatment.
C) encouraging laws that would make the involuntary long-term commitment process
easier and faster for caregivers of mentally ill persons.
D) advocating for reduced mental health insurance benefits to discourage abuse of the
system by inappropriate psychiatric admissions. - ansB) reducing the stigma of mental
illness and advocating for equality in treatment.
Nurses who are aware of legislative concerns and who are active in organizations that
promote mental health awareness and appropriate and equal treatment for mental
illness help achieve the goal of parity, or equality of treatment for mentally ill individuals.
Becoming active in politics may be a personal goal but does not directly or necessarily
reduce stigma or encourage treatment equality. The other options are undesirable
outcomes.
A peer asks you to help him differentiate between culture and ethnicity for clarification.
Which statement by the peer would acknowledge that you had appropriately helped him
clarify the difference between the two terms?
A) "So, ethnicity refers to having the same life goals whereas culture refers to race."
B) "So, ethnicity refers to norms within a culture, and culture refers to shared likes and
dislikes."
C) "So, ethnicity refers to shared history and heritage, whereas culture refers to sharing
the same beliefs and values."
D) "So, ethnicity refers to race, and culture refers to having the same worldview." -
ansC) "So, ethnicity refers to shared history and heritage, whereas culture refers to
sharing the same beliefs and values."
Ethnicity is sharing a common history and heritage. Culture comprises the shared
beliefs, values, and practices that guide a group's members in patterned ways of
thinking and acting. The other options are all incorrect definitions of ethnicity and
culture.
According to the DSM-5, there is evidence that symptoms and causes of mental illness
are influenced by:
A) cultural and ethnic factors. Correct
B) occupation and status.
C) birth order.
D) sexual preference. - anscultural and ethnic factors
,The DSM-5 states there is evidence to suggest that mental illness is influenced by
cultural and ethnic factors. The DSM-5 does not state that there is evidence that
occupation, birth order, or sexual preference affect mental illness.
Bethany, a nurse on the psychiatric unit, has a past history of alcoholism. She has
weekly clinical supervision meetings with her mentor, the director of the unit. Which
statement by Bethany to her mentor would indicate the presence of
countertransference?
A) "My patient, Miranda, is being discharged tomorrow. I provided discharge teaching
and stressed the importance of calling the help line number should she become suicidal
again."
B) "My patient, Laney, has been abusing alcohol. I told her that the only way to recover
was to go 'cold turkey' and to get away from her dysfunctional family and to do it now!"
C) "My patient, Jack, started drinking after 14 years of sobriety. We are focusing on his
treatment plan of attending AA meetings five times a week after discharge."
D) "My patient, Gayle, is an elderly woman with depression. She calls me by her
daughter's name because she says I remind her of her daughter." - ansB) "My patient,
Laney, has been abusing alcohol. I told her that the only way to recover was to go 'cold
turkey' and to get away from her dysfunctional family and to do it now!"
This statement indicates countertransference; Bethany may be overidentifying with the
patient because of her own past history of alcoholism. She is providing adamant advice
to the patient that, besides being nontherapeutic, may be more relevant to her own past
than to the patient's. The discharge teaching for a patient being discharged and
focusing on the treatment plan for the alcoholic patient are appropriate and show no
signs of countertransference. The patient calling the nurse by her daughter's name is
transference rather than countertransference.
George W. Bush's New Freedom Commission on Mental Health's report emphasized
that mental illness is not a hopeless life sentence but a condition from which people can
recover. Recovery, which is still the number 1 goal, could be described as:
A) the ability to work, live, and participate in the community.
B) never having to visit a mental health provider again.
C) a short-term journey that leaves people better able to cope with symptoms.
D) a long-term journey over the individual's life span. - ansA) the ability to work, live,
and participate in the community.
Recovery is described as the ability of the individual to work, live, and participate in the
community. Never having to visit a mental health provider is unrealistic. Recovery is
usually not a short-term journey but rather a long-term journey. While recovery may be
a long-term journey over months or even years, it would not cover an entire life span.
Jacob is a college student whose friend recently committed suicide. Jacob rates his
stress as low. Melissa was also friends with the person who committed suicide, but she
,rates her stress as high. The difference in how Jacob and Melissa rate their stress may
be explained by:
A) projection.
B) denial.
C) perception
D) repression. - ansC) perception
Perception, which is influenced by gender, culture, age, and life experience, plays a part
in how someone will respond to a stress. The perception of a stressor determines the
person's emotional and psychological reactions to it. The other options are all defense
mechanisms that do not explain the difference in reactions to a stressor.
Joel is a 43-year-old patient being seen in the mental health clinic with depression. Joel
states, "I have always been a practicing Jew, but in the past few months I am
questioning everything. I just don't know if I believe in it anymore." Which of the
following nursing diagnoses best describes Joel's comment?
A) Ineffective coping
B) Spiritual distress
C) Risk for self-harm
D) Hopelessness - ansB) Spiritual distress
Joel is expressing distress regarding his religion and spiritual well-being. Joel could be
experiencing ineffective coping, but this does not directly relate to his comment. There
is nothing in Joel's comment that would lead to the conclusion the patient is having
thoughts of harming himself. Joel's comment does not describe hopelessness.
Jonas is a 29-year-old patient with anxiety and a history of alcohol abuse who is an
inpatient on the psychiatric unit. He becomes angry and aggressive, strikes another
patient, and then attacks a staff member. He is taken to seclusion and medicated with
haloperidol and lorazepam. In this case, the haloperidol and lorazepam may be
considered:
A) a restraint.
B) a medication time-out.
C) false imprisonment.
D) malpractice. - ansA) a restraint.
Chemical restraints are defined by those medications or doses of medication that are
not being used for the patient's condition. Medication time-out is incorrect; false
imprisonment and malpractice refer to specific legal terms that do not have any bearing
on this medication scenario.
Josefina Juarez, aged 36 years, comes to the mental health clinic where you work after
being referred by her primary care provider. Josefina came to live in the United States
, from Brazil 5 years ago. She is now a single mother to 6 children, ages 2 to 15,
following the death of her husband last year. During the initial intake assessment,
Josefina tells you her problem is that she has headaches and backaches "almost every
day" and "can't sleep at night." She shakes her head no and looks away when asked
about anxiety or depression and states she does not know why she was referred to the
mental health clinic. You recognize that Josefina may be exhibiting:
A) regression.
B) somatization.
C) enculturation.
D) assimilation. - ansB) somatization.
Somatization is described as experiencing and expressing emotional or psychological
distress as physical symptoms. Regression is a defense mechanism meaning to begin
to function at a lower or previous level of functioning. Enculturation refers to how cultural
beliefs, practices, and norms are communicated to its members. Assimilation refers to a
situation in which immigrants adapt to and absorb the practices and beliefs of a new
culture until these customs are more natural than the ones they learned in their
homeland.
Julie, a 49-year-old patient diagnosed with schizophrenia at 22 years old, is taking
risperidone (Risperdal). Which of the following nursing assessments is the priority
assessment with Julie?
A) Monitoring blood levels to avoid toxicity
B) Monitoring for abnormal involuntary movements
C) Observing for secondary mania
D) Observing for memory changes - ansB) Monitoring for abnormal involuntary
movements
Risperidone has the highest rate of extrapyramidal side effects (EPSs) of the second-
generation antipsychotic medications, thus making it imperative to monitor for EPSs.
Risperidone is not monitored with blood levels and does not cause mania or memory
changes.
Lucas states, "I will always be alone because nobody could love me." This is most likely
an example of:
A) emotional consequence.
B) schema
C) actualization.
D) aversion. - ansB) schema
Schemas are unique assumptions about ourselves, according to Beck's theory. This
statement is an example of a negative schema. Emotional consequence is the end
mental health associations and who keeps aware of state and national legislation
affecting mental illness treatment may positively affect the climate for treatment by:
A) becoming active in politics leading to a potential political career.
B) reducing the stigma of mental illness and advocating for equality in treatment.
C) encouraging laws that would make the involuntary long-term commitment process
easier and faster for caregivers of mentally ill persons.
D) advocating for reduced mental health insurance benefits to discourage abuse of the
system by inappropriate psychiatric admissions. - ansB) reducing the stigma of mental
illness and advocating for equality in treatment.
Nurses who are aware of legislative concerns and who are active in organizations that
promote mental health awareness and appropriate and equal treatment for mental
illness help achieve the goal of parity, or equality of treatment for mentally ill individuals.
Becoming active in politics may be a personal goal but does not directly or necessarily
reduce stigma or encourage treatment equality. The other options are undesirable
outcomes.
A peer asks you to help him differentiate between culture and ethnicity for clarification.
Which statement by the peer would acknowledge that you had appropriately helped him
clarify the difference between the two terms?
A) "So, ethnicity refers to having the same life goals whereas culture refers to race."
B) "So, ethnicity refers to norms within a culture, and culture refers to shared likes and
dislikes."
C) "So, ethnicity refers to shared history and heritage, whereas culture refers to sharing
the same beliefs and values."
D) "So, ethnicity refers to race, and culture refers to having the same worldview." -
ansC) "So, ethnicity refers to shared history and heritage, whereas culture refers to
sharing the same beliefs and values."
Ethnicity is sharing a common history and heritage. Culture comprises the shared
beliefs, values, and practices that guide a group's members in patterned ways of
thinking and acting. The other options are all incorrect definitions of ethnicity and
culture.
According to the DSM-5, there is evidence that symptoms and causes of mental illness
are influenced by:
A) cultural and ethnic factors. Correct
B) occupation and status.
C) birth order.
D) sexual preference. - anscultural and ethnic factors
,The DSM-5 states there is evidence to suggest that mental illness is influenced by
cultural and ethnic factors. The DSM-5 does not state that there is evidence that
occupation, birth order, or sexual preference affect mental illness.
Bethany, a nurse on the psychiatric unit, has a past history of alcoholism. She has
weekly clinical supervision meetings with her mentor, the director of the unit. Which
statement by Bethany to her mentor would indicate the presence of
countertransference?
A) "My patient, Miranda, is being discharged tomorrow. I provided discharge teaching
and stressed the importance of calling the help line number should she become suicidal
again."
B) "My patient, Laney, has been abusing alcohol. I told her that the only way to recover
was to go 'cold turkey' and to get away from her dysfunctional family and to do it now!"
C) "My patient, Jack, started drinking after 14 years of sobriety. We are focusing on his
treatment plan of attending AA meetings five times a week after discharge."
D) "My patient, Gayle, is an elderly woman with depression. She calls me by her
daughter's name because she says I remind her of her daughter." - ansB) "My patient,
Laney, has been abusing alcohol. I told her that the only way to recover was to go 'cold
turkey' and to get away from her dysfunctional family and to do it now!"
This statement indicates countertransference; Bethany may be overidentifying with the
patient because of her own past history of alcoholism. She is providing adamant advice
to the patient that, besides being nontherapeutic, may be more relevant to her own past
than to the patient's. The discharge teaching for a patient being discharged and
focusing on the treatment plan for the alcoholic patient are appropriate and show no
signs of countertransference. The patient calling the nurse by her daughter's name is
transference rather than countertransference.
George W. Bush's New Freedom Commission on Mental Health's report emphasized
that mental illness is not a hopeless life sentence but a condition from which people can
recover. Recovery, which is still the number 1 goal, could be described as:
A) the ability to work, live, and participate in the community.
B) never having to visit a mental health provider again.
C) a short-term journey that leaves people better able to cope with symptoms.
D) a long-term journey over the individual's life span. - ansA) the ability to work, live,
and participate in the community.
Recovery is described as the ability of the individual to work, live, and participate in the
community. Never having to visit a mental health provider is unrealistic. Recovery is
usually not a short-term journey but rather a long-term journey. While recovery may be
a long-term journey over months or even years, it would not cover an entire life span.
Jacob is a college student whose friend recently committed suicide. Jacob rates his
stress as low. Melissa was also friends with the person who committed suicide, but she
,rates her stress as high. The difference in how Jacob and Melissa rate their stress may
be explained by:
A) projection.
B) denial.
C) perception
D) repression. - ansC) perception
Perception, which is influenced by gender, culture, age, and life experience, plays a part
in how someone will respond to a stress. The perception of a stressor determines the
person's emotional and psychological reactions to it. The other options are all defense
mechanisms that do not explain the difference in reactions to a stressor.
Joel is a 43-year-old patient being seen in the mental health clinic with depression. Joel
states, "I have always been a practicing Jew, but in the past few months I am
questioning everything. I just don't know if I believe in it anymore." Which of the
following nursing diagnoses best describes Joel's comment?
A) Ineffective coping
B) Spiritual distress
C) Risk for self-harm
D) Hopelessness - ansB) Spiritual distress
Joel is expressing distress regarding his religion and spiritual well-being. Joel could be
experiencing ineffective coping, but this does not directly relate to his comment. There
is nothing in Joel's comment that would lead to the conclusion the patient is having
thoughts of harming himself. Joel's comment does not describe hopelessness.
Jonas is a 29-year-old patient with anxiety and a history of alcohol abuse who is an
inpatient on the psychiatric unit. He becomes angry and aggressive, strikes another
patient, and then attacks a staff member. He is taken to seclusion and medicated with
haloperidol and lorazepam. In this case, the haloperidol and lorazepam may be
considered:
A) a restraint.
B) a medication time-out.
C) false imprisonment.
D) malpractice. - ansA) a restraint.
Chemical restraints are defined by those medications or doses of medication that are
not being used for the patient's condition. Medication time-out is incorrect; false
imprisonment and malpractice refer to specific legal terms that do not have any bearing
on this medication scenario.
Josefina Juarez, aged 36 years, comes to the mental health clinic where you work after
being referred by her primary care provider. Josefina came to live in the United States
, from Brazil 5 years ago. She is now a single mother to 6 children, ages 2 to 15,
following the death of her husband last year. During the initial intake assessment,
Josefina tells you her problem is that she has headaches and backaches "almost every
day" and "can't sleep at night." She shakes her head no and looks away when asked
about anxiety or depression and states she does not know why she was referred to the
mental health clinic. You recognize that Josefina may be exhibiting:
A) regression.
B) somatization.
C) enculturation.
D) assimilation. - ansB) somatization.
Somatization is described as experiencing and expressing emotional or psychological
distress as physical symptoms. Regression is a defense mechanism meaning to begin
to function at a lower or previous level of functioning. Enculturation refers to how cultural
beliefs, practices, and norms are communicated to its members. Assimilation refers to a
situation in which immigrants adapt to and absorb the practices and beliefs of a new
culture until these customs are more natural than the ones they learned in their
homeland.
Julie, a 49-year-old patient diagnosed with schizophrenia at 22 years old, is taking
risperidone (Risperdal). Which of the following nursing assessments is the priority
assessment with Julie?
A) Monitoring blood levels to avoid toxicity
B) Monitoring for abnormal involuntary movements
C) Observing for secondary mania
D) Observing for memory changes - ansB) Monitoring for abnormal involuntary
movements
Risperidone has the highest rate of extrapyramidal side effects (EPSs) of the second-
generation antipsychotic medications, thus making it imperative to monitor for EPSs.
Risperidone is not monitored with blood levels and does not cause mania or memory
changes.
Lucas states, "I will always be alone because nobody could love me." This is most likely
an example of:
A) emotional consequence.
B) schema
C) actualization.
D) aversion. - ansB) schema
Schemas are unique assumptions about ourselves, according to Beck's theory. This
statement is an example of a negative schema. Emotional consequence is the end
